S. Department of Health and Human Services et al., 2012), and current youth tobacco use is still prevalent; 7% of middle school students and 23% of high school students used any tobacco in 2011 (Centers for Disease CH5424802 purchase Control and Prevention, 2011a). The density of tobacco retailers, particularly

in neighborhoods surrounding schools, has been associated with increased youth smoking rates (Henriksen et al., 2008, Lipperman-Kreda et al., 2012, Loomis et al., 2012, McCarthy et al., 2009 and Novak et al., 2006). Frequent exposure to tobacco retail displays has also been associated with increased smoking initiation among youth (Henriksen et al., 2004, Henriksen et al., 2010 and Johns et al., 2013) and negative impact on tobacco quit attempts (Germain et al., 2010, Hoek et al., 2010 and Wakefield et al., 2008). Lack of enforcement of tobacco sales to minors laws is associated with higher levels of illegal sales to youth (American Lung Association of California and Center for Tobacco Policy and Organizing, 2007, Forster et al., 1998, Ma et al., 2001 and Rigotti et al., 1997). Results from the 2011 National Youth Tobacco Survey found Apoptosis inhibitor that among youth nationwide who were current cigarette users, 44% of middle school students and 51% of high school students reported that they were not refused purchase because of their age (Centers

for Disease Control and Prevention, 2011b). Tobacco retail policies have

demonstrated success in reducing tobacco sales to youth (American Lung Association of California and Center for Tobacco Policy and Organizing, 2007, Ma et al., 2001 and Novak et al., 2006); however, research is limited on whether implementing a tobacco retail permit policy would increase the amount of enforcement heptaminol of laws preventing sale of tobacco to minors. Enforcement of these laws in California has been limited due to lack of funding. One way to remedy this concern is through a local tobacco retail permit which earmarks a portion of the permit fee for enforcement of laws regulating the sale of tobacco. Even less is known about how tobacco retail permitting policies impact youth exposure to and availability of tobacco products through the retail setting (American Lung Association of California and Center for Tobacco Policy and Organizing, 2007, Ma et al., 2001 and Novak et al., 2006). Research on the impact of tobacco retail permit policies on reducing the overall number of stores selling tobacco in a community, including impacts on tobacco retail density and locations near schools, is even more limited. In March 2010, California’s Santa Clara County Public Health Department received funding from the U.S. Department of Health and Human Services through a Communities Putting Prevention to Work grant to support tobacco use prevention and secondhand smoke reduction efforts.